Online Medical Chats

Stroke – Know the Risk Factors & Road to Recovery

Angela (Moderator) - 3:53 PM:Welcome! Today’s chat: Stroke – Know the Risk Factors & Road to Recovery will begin shortly. Please start submitting your questions and Deborah Lynch, Advanced Practice Nurse and Stroke Coordinator will begin answering them as soon as we get started. While you are waiting for the chat to begin, feel free to visit, our Stroke page on the website.
We will do our best to answer all of your questions, but because this is such a popular chat, she may not be able to answer all of your questions in the time allowed. Your understanding is greatly appreciated.

Andrew (Glenview, IL) - 4:01 PM:How long does a typical rehabilitation program last? What are some of the most common exercises and therapies involved in this?

Deborah Lynch (NorthShore):Hi Andrew; every person is different as well as their stroke and rehab. With that said, if patients go to an inpatient rehab program after the acute hospital stay, the mean time is 14-21 days. If a person who has stroke goes to subacute rehab after the hospital stay, this is usually longer with an estimated mean length of stay between 4-6 weeks. Both inpatient rehab and subacute rehab offer physical therapy, occupational therapy, speech therapy and recreation therapy.

Victoria (Chicago, IL) - 4:06 PM:Why is the left-side of the body usually most impacted by a stroke?

Deborah Lynch (NorthShore):Victoria- in our practice here at Evanston Hospital, we see an equal number of patients with left/right sided weakness.
With left sided weakness- the right hemisphere of the brain has been injured; and vice versa with right sided weakness (left hemisphere).

Tim (Chicago) - 4:10 PM:My 80-year old mother had a stroke about 10 days ago. She seemed to be more mobile and “back to normal” immediately after the stroke. Since then, she has numbness, trouble talking and moving around. Is it common for symptoms to worsen with time?

Deborah Lynch (NorthShore):Hi Tim- certain strokes have a tendency for symptoms to worsen. (2 such areas are subcortical strokes and pontine infarcts). If worsening occurs it usually happens in the first 48-72 hours but can occur up to 2 weeks following stroke. Sometimes this worsening indicates increased injury to the area of the original stroke; other times it can be related to an infection or metabolic issue that causes the original symptoms to look worse (although when the infection is treated or metabolic issues corrected, the person will return to previous functional state)

Amy (Skokie, IL) - 4:15 PM:My father gets a TIA every few months, usually never lasting more than a minute. Is he at a greater risk of suffering from a stroke as a result? What can he do to prevent this?

Deborah Lynch (NorthShore):HI Amy. TIAs (transient ischemic attacks) are definitely warning signs to stroke. However, when someone has repeated events that are called TIAs and the symptoms are similar from one event to another, it suggests that this may be a stroke mimic, not a true vascular event. Two common stroke mimics (conditions that can look stroke-like) are partial seizure and complex migraine (with or without headache). It is important to get a thorough stroke workup to try and sort this out.

Dan (Wilmette) - 4:21 PM:How direct is the connection between diet and stress levels to suffering from a stroke? Is there anything that can be done to prevent having one?

Deborah Lynch (NorthShore):HI Dan. We know that high levels of LDL (bad cholesterol) can contribute to atherosclerosis (hardening of the arteries) which can narrow the blood vessels that provide circulation to the brain. Strokes can occur when small blood vessels in the brain become narrow. Diet contributes to LDL levels but sometimes high levels of LDL are familial and medications (statins) need to be taken to lower risk of atherosclerosis.
Stress levels - we all have stress. Acute stress (not the chronic type) can lead to hypertension (high blood pressure) and again, over the course of time, contribute to atherosclerosis and small vessel disease (risk factor for stroke).
Our best primary stroke prevention is to try and identify your stroke risk factors and lower them as best as you can.

Jen (Berwyn) - 4:29 PM:I get frequent migraine headaches. Since the symptoms can sometimes be very similar to stroke symptoms, how do I know I’m suffering from more than just a severe headache?

Deborah Lynch (NorthShore):Complex migraines can mimic stroke symptoms; for instance- one sided facial weakness/numbness, one-sided weakness/numbness, speech/language difficulties. There is no good way for a person to determine the difference; we will work person up in the hospital for stroke and "rule out" stroke before concluding symptoms were from migraine. Stroke is the most dangerous- we treat as if stroke unless proven otherwise.
FYI- headache is not usually stroke-like unless it is from a hemorrhagic (bleeding) stroke. CT head will be done to rule this out.

Curtis (Evanston) - 4:35 PM:I recently suffered from a “mini stroke” and still seem to have some residual side effects. Is this normal? I thought they would go away after 24 hours.

Deborah Lynch (NorthShore):HI Curtis. There is some confusion with the term "mini-stroke". I think we like to think a small stroke is "mini"; but other persons may refer to mini stroke as TIA (transient ischemic attack).
The definition of TIA is transient stroke like symptoms that usually resolve within one hour and there are no imaging changes (meaning- no stroke seen on either MRI or CT head. If you had a small stroke, symptoms may persist for awhile or longer; TIA- your symptoms should have been resolved and you should be re-evaluated by your neurologist.

anne (chicago) - 4:43 PM:My husband has heart problems and high blood pressure. He has been complaining lately about feeling weak and dizzy. Could it be possible he suffered from a TIA? What are some warning signs for further complications we should be aware of?

Deborah Lynch (NorthShore):Generalized weakness is not "stroke-like"; the term dizziness which can be a stroke symptoms, is often used when a person really has light-headedness (not a stroke symptom).
Signs of TIA are similar to stroke.
FAST-
F= facial weakness
A= arm/leg weakness/numbness
S= Speech or language difficulty
T= timing- get to the Emergency Room as soon as possible. Time is brain so getting good circulation to the brain is imperative
Sounds like your husband probably has a Cardiologist - it may be a good time to seek his/her attention.

Angela (Moderator) - 4:48 PM:Thank you everyone for your great participation. The chat will be ending in approximately 10 minutes. Please submit your final questions.

Beth (Evanston) - 4:50 PM:My husband had a stroke a few years ago. He has generally recovered well, but more recently I have noticed some rather significant behavioral changes. He gets irritable very quickly now and makes quick, irrational decisions. Could this be an after effect from his stroke?

Deborah Lynch (NorthShore):If he only recently has become more irritable and decision-making more impaired, he probably needs to see his PCP or neurologist to make sure there isn't something else contributing to his overall state of physical/mental health. These are not "stroke-like" symptoms but sudden changes in behavior in someone who has already had a stroke, is worth investigating further

Adam (Chicago) - 4:55 PM:What testing can be done to check for blood clots in the brain that may trigger a stroke? If blood clots are common in my family should I be more concerned?

Deborah Lynch (NorthShore):If you have a family tendency for clotting, there are several blood tests that your PCP/neurologist can check to see if you are more prone to clot.
We do not routinely perform CT scans of the head or MRIs of the head unless a person has stroke-like symptoms (so no diagnostic testing of the brain to see if you are at risk for stroke).

Diane (Chicago) - 4:59 PM:Why is it so important to get medical attention fast? What can a bystander do to help if someone is having a stroke?

Deborah Lynch (NorthShore):Brain cells (neurons) die within seconds of not receiving oxygenated blood. For this reason, the faster a person with stroke symptoms gets to the ED the better. Person may be candidate for our only FDA approved treatment for acute stroke- tPA (alteplase); but this can only be administered if symptom onset is less than 3-4.5 hours from time of drug administration.
If you witness someone that may be having stroke, call 911!!

Angela (Moderator) - 5:02 PM:Thank you for participating in our online chat today. An online transcript will be available shortly.